Objective To provide clinical evidence for the relationship between epithelial-mesenchymal transition (EMT) and colorectal cancer(CRC) by detecting the expression of TGF-β, Smad-3 and Smad-7 in serum from CRC patients. Methods We detected the expression levels of TGF-β1 , Smad-3 and Smad-7 by ELISA method. Results The expression levels of TGF-β1 , Smad-3 were significantly higher and the Smad-7 was significantly lower in CRC patients than those in control group(P<0. 01). The expression levels of TGF-β1 and Smad-3 were signifi-cantly higher in Dukes D than those in Dukes B,C. The Smad-7 was significantly lower in Dukes D than that in Dukes B,C(P<0. 01). Conclusion TGF-β1 and Smad-3 and Smad-7 may play an important role in the develop-ment of CRC.

BACKGROUND:Studies concerning bone marrow mesenchymal stem cells (BMSCs) cultured by umbilical cord serum in vitro were hot topic to avoid the heterogenous serum rejection during BMSC culture and improve culture efficiency of BMSCs.OBJECTIVE:To compare biological feature of BMSCs by the umbilical cord serum and adult autoserum in vitro.DESIGN,TIME AND SETTING:The opening experiment was performed at the Laboratory of Cell Biology,Xiangya Second Hospital,Central South University,China from October 2006 to June 2008.MATERIALS:Sixteen bone marrow samples were provided by Xiangya Second Hospital,Central South University and Xiangtan Central Hospital of Hunan Province.METHODS:BMSCs were obtained from 16 fresh adult bone marrow by gradient centrifugation with Ficoll Paque,cultured with DMEM/F12 with 10% umbilical cord blood serum and 10% adult autoserum.The fourth passage was used in this study.The surface antigens of BMSCs were detected by flow cytometry.BMSCs could differentiate into ostenblasts and adipocytes under culture in conditioned medium for osteogeneais and adipogenesis and the differentiated BMSCs were identified by morphological observation,immunophenotype and immunochemical staining.MAIN OUTCOME MEASURES:The following parameters were measured:morphological observation;cell cycle and cell count;identification of surface antigen;observation of osteoblasts and adipocytea induced from BMSCs by immunochemical staining.RESULTS:The quantity and velocity of BMSCs in umbilical curd blood serum was better than those in adult autoserum (P ＜ 0.05)Only few cells were proliferating in both medium,BMSCs in S phase in umbilical cord blood serum was more than those in adult autoserum (P ＜ 0.05).The positive rate of CD29,CD73 and CD105 on BMSCs in umbilical cord serum (above 90%) was higher than those in adult autoserum (P ＜ 0.05),and the positive rates of CD31,CD34 and CD45 were lower than 2%,and the positive rate of CD31 was lower than those in adult autoserum (P ＜ 0.05).The positive rate of BMSCs differentiated into osteoblasts and adipocytes in umbilical cord blood serum was also higher than these in adult autoserum (P ＜ 0.05).CONCLUSION:Purity and differentiated potency of BMSCs in umbilical cord blood serum are better than those in the adult autoserum in vitro.The umbilical cord serum is more adapt to clinical application.

Objective To explore the management of perioperative period on the effect of alimentary tract fistulas after gastric cancer operation.Methods The clinical data of 25 patients with alimentary tract fistulas after gastric cancer operation were reviewed.The location and time of alimentary tract fistulas,and perioperative period of patients were analyzed.Results Of the 25 patients,13 cases(52.0％) were anastomotic fistulas,1 case(4.0％) was bile fistula,2 cases (8.0％) were pancreatic fistulas,4 cases (16.0％) were small intestinal fistulas,and 3 case (12.0％) were duodenal stump fistulas,1 case (4.0％) was anastomotic and duodenal stump fistula,1 case (4.0％) was small intestinal and duodenal stump fistula.The alimentary tract fistulas generally occurred within the first or second week after gastric cancer operation.The incidence rate of gastrointestinal leakage was 64.0％ in gastric cancer with diabetes patients,56.0％ in gastric cancer with elderly patients,40.0％ in gastric cancer with anemia patients,36.0％ in gastric cancer with hypoproteinemia patients,16.0％ in gastric cancer with multivisceral excisions.21 cases of gastrointestinal leakage were healed after conservative treatment.2 cases with gastrointestinal leakage by operation treatment were healed.2 patients died,one died of intra-abdominal hemorrhage,one case died of MODF.Conclusion Strengthening the management of patients with alimentary tract fistulas after gastric cancer operation can promote the healing of fistula in perioperative period.

Objective To investigate the changes of T cells and dendritic cells (DCs) and their related factors in children with immune thrombocytopenia (ITP) before and after therapy,and to analyze their clinical significance.Methods T-cells and DCs subsets were determined by flow cytometry both in 64 children with ITP (ITP group) before and after therapy and the control group.The serum levels of interleukin (IL)-4,interferon-γ (IFN-γ),transforming growth factor beta 1 (TGF-β1),and IL-27 were detected by enzyme linked immunosorbent assay (ELISA).Results Treatments of glucocorticoid or IVIg were effective in 41 cases of 64 ITP children.Compared to the control group,helper T cells (Th),Th/suppressor T cells (Ts),T regulatory cells (Treg),plasmacytoid DC (pDC),pDC/myeloid DC (mDC),and TGF-β1 in ITP patient group before treatment were significantly lower,while IFN-γ and IFN-γ/IL-4 were significantly higher (P ＜0.05).In ITP group,Th,Th/Ts,Treg,pDC,pDC/mDC,TGF-β1,and IL-27 were significantly increased,while IFN-γ and IFN-γ/IL-4 were decreased in children with ITP after therapy and achieved response (P ＜ 0.05).However,there was no significant difference between before and after therapy in ITP children without treatment response (P ＞ 0.05).Conclusions T cells and DCs subsets disorder and abnormal cytokine levels are observed in children with ITP,which can be corrected by immunosuppressive therapy,indicating that Th1 overactivity and the decrease of Treg and pDC both in quantity and function may be related to the pathogenesis of ITP in children.

OBJECTIVE: Comparative analysis of the clinical curative effect of manipulative reduction and TRV- CRP treatment of BPPV, comfort degree during reset and quality of life improvement. METHOD: One hundred and thirty-two patients with BPPV were randomly divided into two groups ,one group underwent the traditional manip- ulative reduction, the other group with TRV-CRP. DRI and VAS was evaluated in the pre and after treatment and evaluation of the efficacy was conducted. The results of two groups were compared. RESULT: The effective rate of manipulative reduction after a week treatment was 89. 23% and TRV-CRP.was 98. 51%, which was higher in TRV-CRP group than that of the manipulation reduction group(P<0. 05). The comfort degree of the manipulation reduction group was 4. 54±2. 48,higher than the TRV-CRP group which was 5. 48±1. 44 (P<0. 05). The score of DHI showed no significant difference before treatment between manipulation reduction group and TRV-CRP group(P>0. 05), the score of the two groups were decreased after a week of reduction, but the improvement of TRV-CRP group was higher than that of manipulation reduction group(P<0. 05). CONCLUSION The success rate of TRV-CRP was higher than that of manipulative reduction,but manipulative reduction comfort degree was higher than TRV-CRP, the two methods can both improve the quality of life of patients with BPPV. TRV-CRP has many advantages over manipulative reduction, but manipulative reduction is simple with low cost, and the effect is still a great advantage. In clinical work, we should reasonable combine the two methods,so as to improve the cure rate of RPPV.
Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Patient Positioning ; Quality of Life ; Treatment Outcome

Objective To investigate the significance of tumor markers CEA and CA19-9 in predicting the clinicopathologic characteristics and prognosis of primary duodenal carcinoma.Methods A retrospective analysis of 110 cases with primary duodenal carcinoma treated in our hospital from January 1999 to December 2016 was conducted.ROC analysis,univariate and multivariate analysiswere performed to investigate the relationship between CEA,CA19-9 and the clinicopathologic characteristics of primary duodenal carcinoma.Kaplain-Meier method was used to analyze the relationship between CEA and CA19-9 and the prognosis of primary duodenal carcinoma.Results CEA level was of value for predicting the depth of infiltration,lymphatic involvement,metastasis and TNM stage.The receiver operating characteristic was 0.629,0.672,0.749,0.692 respectively.Univariate analysis showed serum CA19-9 lever was related to the depth of infiltration and serum CEA lever were related to tumor differentiation,lymphatic invasion,metastasis and TNM stage.Logistic analysis showed that CEA value was only associated with metastasis (OR:9.853,P ＜ 0.01).Patients with elevated serum CEA level had a significant worse prognosis than patients with normal serum CEA level (P ＜ 0.05).Conclusion Serum CEA level was closely associated with the clinicopathologic characteristics and prognosis of primary duodenal carcinoma.

Objective:To investigate the anti-leukemia effect of icaritin on 697 cells of children relapsed acute lymphoblastic leukemia in vitro, and to analyze its possible mechanism. Methods:697 cells were cultured in vitro and divided into control group and icariin groups (5, 10, 20 μmol/L). After treated with icaritin, the cell proliferation was detected with cell counting kit-8 (CCK-8) method, and apoptosis was measured with Hoechst 33258 staining and Flow Cytometry Assay. Expression of Bcl-2, Cyt-C, Bax and Caspase3 proteins in 697 cell were detected by Western blot. Results:After treatment with various concentrations (5-20 μmol/L) of icaritin for different time-points (24, 48, 72 h), the growth inhibition rate exhibited a dose and time-dependent manner ( r=0.76, r=0.89); the apoptotic rate exhibited significant increase for 48 h ( P<0.05). Bcl-2 protein decreased significantly ( P<0.05), while Bax, Cyt-C and Caspase3 cleavage protein increased significantly in icaritin treated group for 48 h compared with control group ( P<0.05). Conclusions:Icaritin shows the effects of anti-leukemia by inducing apoptosis and inhibiting proliferation of 697 cell. Icaritin maybe induce apoptosis of 697 cell by down-regulation of Bcl-2 expression and up-regulation of the Bax, Cyt-C and cleaved Caspase 3 expression.

Objective:To investigate the changes of regulatory B cells (Bregs) and lymphocyte subsets in children with primary immune thrombocytopenia (ITP), and to analyze their relationship with ITP duration and remission time.Methods:Proportion of different immune cell subsets were detected in the peripheral blood of 88 ITP children before treatmen, 84 ITP children after treatmen and 45 normal controls by flow cytometry. The treatments included glucocorticoids, intravenous IgG as first-line treatment. The changes of lymphocyte subsets in ITP children with different remission time after treatment were compared.Results:The Th, natural killer (NK), Breg cell counts and Th/Tc ratio in all children with ITP were significantly lower than those in the control group ( P<0.05), while the Tc and CD19 + B cells were significantly higher than those in the control group ( P<0.05). The Breg cell count in the persistent and chronic ITP groups was significantly lower than that in the newly diagnosed ITP ( P<0.05). A total of 84 children with ITP were relieved after treatment: 58 cases (69.1%) achieved long-term remission, and 26 cases (30.9%) had short-term remission. The Breg and lymphocyte subsets in the short-term remission ITP group after treatment were not significantly different from those before treatment, but there were still significant differences from the control group ( P<0.05); The Breg and lymphocyte subpopulations in the long-term remission ITP group after treatment were not significantly different from those in the control group, but compared with those before treatment, other cell subpopulations except Tc were significantly increased ( P<0.05); The NK cells and Breg cells in the long-term remission ITP group were significantly higher than those in the short-term remission ITP group ( P<0.05). Conclusions:The Bregs in peripheral blood of long-duration ITP children significantly decrease. After treatment, the Bregs in ITP children with long-term remission increase significantly, indicating that the restoration of the immune mechanism of Bregs may be related to the long-term remission of children with ITP.

Objective To explore the curative effectiveness of comprehensive voice training methods on teachers' voice disorders patients by using subjective and objective assessment. Methods Forty-seven teachers' voice disorders patients suffering from voice symptoms without organic disease and complete follow-up data as the research object were treated with a three-month comprehensive voice training program. Training content included relieving laryngeal muscle tension, improving the throat vocal cord movement and reconstruction methods of pronunciation. The use of voice acoustic analysis and voice handicap index(VHI) were compared before and after training. Results The jitter and shimmer were significantly decreased after comprehensive voice training from 1.06(0.79,1.38)％and 2.71(2.16,3.24)％to 0.78 (0.59, 0.99)％ and 1.64(1.03,2.45)％, the differences were significant (Z=3.249,-4.121, P<0.05). Maximum phonation time and dysphonia severity index were significantly increased obviously from (9.87 ± 2.61)s and-2.23±0.75 to (12.81±1.97)s and-0.43±1.65 respectively, the differences were significant (t=-6.057,-5.273, P<0.05). After the training, the VHI score of voice disorder index decreased from (37.41±4.96)points to (26.31± 4.29) points after the comprehensive voice training. In addition to emotional function, the difference was statistically significant(t=12.715, 5.881, 11.483, P<0.05). Conclusions Voice training can reduce the degree of voice disorders effectively, increase the power of the respiratory system, therefore improve the voice quality of teachers with voice disorders. The subjective and objective combination assessment can evaluate the quality of the patient′s voice more thoroughly and evaluate the clinical efficacy of voice training further.

OBJECTIVETo study the clinicopathologic features and pathologic diagnosis and differential diagnosis of angioimmunoblastic T-cell lymphoma with HRS-like cells.

METHODSSix cases of angioimmunoblastic T-cell lymphoma with HRS-like cells were examined histologically and immunohistochemically (EliVision method) and in-situ hybridization for Epstein-Barr virus-encoded RNA (EBER), and the literature was reviewed.

RESULTSThe cytologic and microscopic features of these imprints and lymph node samples showed a heterogeneous population of hematolymphoid cells, including small to intermediate lymphoid cells, immunoblasts, plasma cells, dendritic cells, and eosinophils, as well as small vessels that were surrounded by some of the abnormal cells. The neoplastic T-cells expressed CD3 and CD5 and partly positive for CD10 and bcl-6, CD21 showed expanded and irregular follicular dendritic cell (FDC) meshworks that surrounding the high HEV. The HRS-like cells were positive for MUM-1 and Ki-67, variable intensity positive for CD30, CD20, and PAX-5, but negative for CD15. EBV-positive cells included HRS-like cells and small to large-sized neoplastic T-cells, which formed small clusters or scattering in the background of the disease.

CONCLUSIONSThe clinical course of angioimmunoblastic T-cell lymphoma with HRS-like cells is aggressive. Which present with histomorphology overlap with classical Hodgkin lymphoma (CHL), similar to CHL in EBER and immunophenotype, however, it is easy to misdiagnosis as HL. Thus, angioimmunoblastic T-cell lymphoma pathology diagnosis should comprehensive analysis of different kinds of materials, including clinical features, and histological structure, and EBER, and immunophenotype, and gene rearrangement.

Diagnosis, Differential ; Herpesvirus 4, Human ; Hodgkin Disease ; pathology ; Humans ; Immunoblastic Lymphadenopathy ; diagnosis ; pathology ; Immunohistochemistry ; Immunophenotyping ; In Situ Hybridization ; Lymphoma, T-Cell ; diagnosis ; pathology ; RNA, Viral ; Reed-Sternberg Cells ; pathology ; T-Lymphocytes ; pathology